17 Form 1099-SA (Rev. April 2025) For calendar year Distributions From an HSA, Archer MSA, or Medicare Advantage MSA 1 Gross distribution 2 Earnings on excess cont. $ $ RECIPIENT S name 3 Distribution code 4 FMV on date of death Street address (including apt. no.) 5 HSA PAYER S TIN RECIPIENT S TIN $ City or town, state or province, country, and ZIP or foreign postal code Account number (see instructions) Archer MSA MA MSA Copy A For Internal Revenue Service Center For fil.

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The prep of legal papers can be costly and time-consuming. However, with our pre-built web templates, everything gets simpler. Now, working with a 1099-sa takes not more than 5 minutes. Our state online samples and simple guidelines eliminate human-prone mistakes.

Follow our easy steps to have your 1099-sa prepared rapidly:

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